Moving to a Neuroscience Service Line approach expands patient care, builds provider cohesion

Chief Pediatric Neurosurgeon Daniel Guillaume, MD, MS, co-leads the M Health Fairview Neuroscience Service Line with Sarah Benish, MD, of the Neurology Department.

What is a service line?
According to Agilum Healthcare Intelligence, “a service line is a specific grouping or population of ‘like’ patients and is based on patient encounter attributes such as:

  • Inpatient versus outpatient
  • Major disease categories
  • Diagnosis-related groups
  • ICD [International Classification of Diseases] procedure codes
  • Healthcare Common Procedure Coding System codes.”

Why does it matter?
Dr. Guillaume’s work on the Neuroscience Service Line has an important effect on patients, providers, residents, and communities. To explain what that means, it helps to understand the significant Service Line changes that were recently announced.

For example, Bethesda Hospital in St. Paul, MN, will be converted by yearend from its current role as a COVID-19 hospital to a homeless shelter to help mitigate the growing homeless problem in Ramsay County, according to Dr. Guillaume. “They’re working as fast as they can, given the upswing in COVID cases in the area,” he said.

Regionalizing the practice
From a neurosurgical standpoint, the biggest change affects M Health Fairview St. Joseph’s Hospital in St. Paul, MN — the oldest hospital in Minnesota. It will take on the responsibility for COVID-19 cases and stop being an acute care facility around the same time as the Bethesda transition. “Neurosurgeons who practice at St. Joseph’s will move to other hospitals, such as M Health Fairview St. John’s Hospital in Maplewood, Minnesota,” said Dr. Guillaume. Neurosurgical cases from St. Joseph’s will also go to M Health Fairview Ridges Hospital in Burnsville, MN; M Health Fairview Southdale Hospital in Edina, MN; and to the University of Minnesota Medical Center in Minneapolis, MN. “The neurosurgeons from St. Joseph’s will eventually join our other community neurosurgeons under Dr. Anthony Bottini’s leadership,” said Dr. Guillaume.

How does this benefit patients?
“We’re coming together as a single system, instead of having fragmented pockets of providers,” he explained. “Neurosurgical cases are complex and require complex equipment and tools. By regionalizing our practice, we can offer more to our patients. By centralizing, we can move complex cases to certain hospitals, therefore providing a higher level of care for our patients. We are also becoming a more cohesive team, benefitting from being part of a larger group.”

Guillaume added that because everyone is good at certain things, the Neuroscience Service Line can bring more resources to bear on patients’ cases. And because there are more neurosurgeons in the pool, so to speak, being on call becomes less burdensome for the providers. Residents will eventually benefit from these changes as new sites become available for training opportunities.

Engaging everyone in the vision
The new provider team is having weekly meetings with Dr. Bottini. “He’s the bridge between the two groups,” explained Dr. Guillaume. “We’re engaging everyone to help create a common vision for delivering care.”

Building standardized care pathways
Daniel Guillaume, MD, MSAttention is also being paid to patient care and what is known as Care Pathways. “When patients come in with a stroke, for example, they will get the same care throughout the system,” said Dr. Guillaume (pictured at left) . “If care is delivered in the best way using proven approaches, patients have better outcomes — no matter which hospital they go to.”

M Health Fairview is currently rolling out stroke and cervical spine Care Pathways. “We’re starting to work on epilepsy and endovascular care, meeting with all the specialized care teams to develop these pathways,” said Dr. Guillaume. “We’ve created step-by-step order builds in the electronic patient care system so it’s easy to provide consistent care. We’ve also developed metrics by which we’ll measure patient outcomes.”

As he looks back over the past year, Guillaume notes, “Despite the hurdles faced in 2020, significant positive changes have been made throughout the M Health Fairview system and we are looking forward to continued improvements as we transition to 2021.”

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